DR. JORDAN JOHN MICHELENA MD NPI 1396891057

NPI Information

NPI: 1396891057
Provider Name: DR. JORDAN JOHN MICHELENA, MD
Classification: General Practice - 208D00000X
Entity Type: Individual
Organization: BLACK ROCK MEDICAL CARE INC

PECOS Registration: Yes

Address:
4477 WHITTIER BLVD
LOS ANGELES, CA
ZIP 90022
Phone: (323) 264-2890
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DR. Jordan John Michelena, MD is a general practice in Los Angeles, CA with 18 years of experience. DR. Jordan John Michelena, MD NPI is 1396891057. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2006

The provider's business location address is:

4477 WHITTIER BLVD
LOS ANGELES, CA
ZIP 90022-535
Phone: (323) 264-2890

The NPI 1396891057 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/26/2007 and was last updated on 8/19/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		A101937	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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